Does Vigilance in Caregiving Decision Making Matter?

Research Objective : Family responsibility and societal expectations often put caregivers in conflict regarding the decisions they must make. Janis & Mann’s (1977) conflict model describes vigilance as high-quality decision making resulting in optimal outcomes. The intention behind this research was to determine whether caregivers may benefit from interventions assisting them to be vigilant decision makers. Our objectives were threefold: 1) to identify decision styles of dementia family caregivers; 2) to examine their socio-economic characteristics; and 3) to determine whether vigilant caregivers report fewer caregiving problems.

Study Design: Our analysis was based on 639 survey respondents recruited from a university affiliated memory disorders clinic. We used regression methods to determine whether various outcomes could be explained by decision style, caregiver characteristics, conflicting obligations, and caregiver objective burden.

Population Studied: Our typical caregiver was Caucasian, non-Hispanic, currently married and had 2.1 children.

Principal Findings: Approximately half of our sample used a pure vigilant decision style. Males with higher education were more likely to be vigilant decision makers. Vigilance was related to nine measures of caregiver outcome and was unrelated to the socio-demographic characteristics.

Conclusion: Approximately half (44.0%) of our dementia family caregivers’ sample used a pure vigilant decision style. Males and those with higher education were more likely to be vigilant decision makers. The vast majority (98.2%) of people who had a “pure style” were vigilant, thus, supporting the theory which states that vigilant people tend to be strictly vigilant (Janis & Mann, 1977). Most of our respondents (96.4%) agreed with at least one statement indicative of vigilance. Our results also support the theory which states that non-vigilant people will vacillate between the maladaptive styles – perhaps, reacting to the influence of environmental factors (Janis & Mann, 1977).

Implications for Policy, Delivery or Practice: Supporting caregivers to become vigilant decision makers would not only have major impact on the caregiving experience, it is a functionally viable intervention.